Minimally Invasive plate Osteosynthesis technique for Commin
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Nonunion is a rare complication for distal fibular fractures. A novel technique was described that used the oblong hole of a locking plate to lengthen the fibula for fracture reduction. This technique is straightforward and allows for easy control of the comminuted fracture to restore length and rotation at the time of plate application without opening the fracture site.

A retrospective research was performed on 35 patients who had comminuted distal fibular fractures and were treated with the minimally invasive plate osteosynthesis (MIPO) technique. There were 19 men and 16 women in the survey, with an average age of 47.0 years.

3 deltoid-damaged lateral malleolar fractures, 11 bimalleolar fractures, 7 trimalleolar fractures, and 14 distal tibiofibular fractures were discovered. The quality of fracture reduction was determined by comparing the radiologic parameters (fibular length, talocrural angle, and medial clear space) of the affected and contralateral uninjured ankles.

Results:
--2 patients were not reachable and 5 declined to visit the clinic.

--For these 7 patients, the latest outcomes that were measured prospectively were used.

--Postoperative radiographs showed well-aligned ankle mortise, with fibular length restoration.

--The mean Olerud-Molander ankle score was 82.1 ± 10.7 at a mean of 27.2 months (range, 12 to 58). There was one case of nonunion and one case of superficial peroneal nerve injury.

Finally, the MIPO technique using the oblong hole of a locking plate resulted in sufficient length and rotation recovery, bone union, and clinical results for comminuted distal fibular fractures.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02441-2
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